April 2017

Contributed by: Mahboobeh Ghesmaty Sangachin, PhD Candidate & Lora Cavuoto, PhD. Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY

Issue #51

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Why Health Promotion at Work?
Work characteristics affect employees’ health behavior and outcomes. For instance, a stressful work environment, in which employees perceive an imbalance between their effort and the resulting rewards, is a risk factor for alcohol dependency1. Similarly, high job control and its interaction with job demands can facilitate leisure time physical activity2. On the other hand, an employee’s health has clear implications for their work performance and employer-paid healthcare costs. This two-way relationship between work and health makes the workplace an ideal platform for health promotion activities.
The Problem of Low Participation in Health Promotion Programs 
However, low participation rates (highly variable, but typically below 30%) and a failure to deliver activities workplace wellness programs (WWPs) to those with the highest health risks3 may limit the effectiveness of these programs and weaken the business case for organizational managers. It is critical to identify both personal and organizational barriers, facilitators and motivators to worker program participation.
Some work-related factors contribute to employees’ decision to participate in WWPs, reflecting the interactions between the employee and his/her perception of the job, the employer, and the surrounding work environment and are major occupational safety and health concern. For instance, white-collar workers with secure contracts and full-time workers are reported to have higher participation compared to workers on shift work4. Work psychosocial factors that play a significant role in forming the mental and physical well-being of employees are likely to have an effect on WWP participation as well5.
Psychosocial Work Characteristics Associated with Participation – New Findings
In a study at a large public university, 350 employees responded to questions about psychosocial factors at work; their current participation level (non-participant, participant, or ‘engaged’ participant (at least once a month)) in diverse WWPs; and their likelihood of future participation.  Selected employees were then invited for focus groups and interviews to elaborate on their opinions about their work environment experience and its impact on WWP participation.
With regard to current participation status:
  • Respondents with high job control were more likely to participate in WWPs: 
    • Flexible working hours were stated as a primary facilitator of participation.
  • High job control and high supervisor support combined were associated with engaged participation: 
    • When all employees benefit from supervisor support, perception of favoritism does not turn into a barrier for WWP participation.  
  • Low supervisor support, but in combination with very high job demands and high control, was also associated with participation. 
    • High stress resulting from very high working demands may motivate employees to seek relief through participating in WWPs. Moreover, high levels of job control allowed them to manage both occupational and WWP-related activities.
  • For men, being single and perceiving high work centrality were predictive of participation. 
  • For women, high work-family conflict was associated with non-participation. Among those with moderate work-family conflict (only), being single was associated with participation. 
With regard to likelihood of future WWP participation:
  • Predictability of work activities in the forthcoming months was identified as a significant factor.
  • High control at work and peer support were associated with highly probable future WWP participation.
    • Membership in thriving work teams has encouraged employees to try WWP participation.
The Take-Away Messages
  • Job offering very high demand and control, low demand and moderately high control and high control and supervisor support are more likely to encourage WWP participation. 
  • Flexible working hours add an element of control and enable employees to set their schedules based on occupational and personal needs.
  • Prevailing gender role expectations and high work-family conflict may inhibit female employees from taking advantage of the resources available to them at work to enhance their well-being.
  • Successful implementation of WWPs requires ensuring that occupational barriers to participation are properly addressed through a holistic approach to employee well-being.
References
  1. Head J., Stansfeld S.A., Siegrist J. (2004) The psychosocial work environment and alcohol dependence: a prospective study. Occup Envir Med, 61(3), 219-224. 
  2. Choi B., et al. (2010)  Psychosocial working conditions and active leisure-time physical activity in middle-aged US workers. Internat J Occup Med Envir Health, 23(3), 239-253. 
  3. Thompson S.E., et al. (2005)  Factors influencing participation in worksite wellness programs among minority and underserved populations. Family Commun Health, 28(3), 267-273.
  4. Morris W.R., Conrad K.M., et al. (1999)  Do blue-collar workers perceive the worksite health climate differently than white-collar workers? Amer J Health Promot, 13(6), 319-324.
  5. Jørgensen M.B., et al. (2016)  Does employee participation in workplace health promotion depend on the working environment? A cross-sectional study of Danish workers. BMJ Open, 6(6), e010516.
Mahboobeh Ghesmaty Sangachin is a PhD candidate in the Dept. of Industrial and Systems Engineering at University at Buffalo, focusing on ergonomics and macro-ergonomics. 
Lora Cavuoto is Assistant Professor at the same department. Her work addresses the effects of health conditions, obesity and aging on work performance and occupational injury risk in order to design effective workplace interventions. 
Acknowledgment 
This work was supported by the CPH-NEW pilot grant program from the National Institute for Occupational Safety and Health (NIOSH). The contents are solely the responsibility of the authors and do not necessarily represent the official views of NIOSH.
CPH-NEW is a Center for Excellence to Promote a Healthier Workforce of the National Institute for Occupational Safety and Health. CPH-News & Views is a semi-monthly column written by Center researchers on emerging topics related to healthy workplaces. These comments reflect thoughts of the individual researchers and do not represent conclusive research summaries, nor do they necessarily reflect a consensus among all Center personnel.
We welcome your responses and discussion.  Please send all questions and comments to CPHNEW@uml.edu.